Complete pathologic response as a prognostic factor for squamous cell carcinoma of the oropharynx post-chemoradiotherapy

Trufelli, Damila Cristina; Matos, Leandro Luongo de; Santana, Thaiana Aragão; Capelli, Fábio de Aquino; Kanda, Jossi Ledo; Giglio, Auro del; Castro, Gilberto de

doi:10.1016/j.bjorl.2015.07.009

Cited by 3 publications

(4 citation statements)

References 37 publications

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“…The presence of viable tumoral cells in planned neck dissections after previous treatment with radiotherapy or chemoradiotherapy (pN+) has been associated to higher rates of local 1,16,21 and regional 2,11,13,14,19,20,26 failures, higher rates of appearance of distant metastases, 3,21,23,26 and poorer overall 11,12,15,18,22 and specific-disease survival. 5,9,10,14,17,20,21,[23][24][25][26] However, there is little information about the pathologicl characteristics of the positive neck metastases in relation to the prognosis of the disease. In a study carried out in 12 patients with N2-N3 tumors treated with radiotherapy or chemoradiotherapy and a planned neck dissection with positive lymph nodes, Lavertu et al 9 found that presence of ECS (n = 7) carried a worse prognosis, but because of the small number of patients the difference was not statistically significant (P = .09).…”

Section: Discussionmentioning

confidence: 99%

“…The presence of viable tumoral cells in planned neck dissections after previous treatment with radiotherapy or chemoradiotherapy (pN+) has been associated to higher rates of local and regional failures, higher rates of appearance of distant metastases, and poorer overall and specific‐disease survival . However, there is little information about the pathologicl characteristics of the positive neck metastases in relation to the prognosis of the disease.…”

Section: Discussionmentioning

confidence: 99%

“…Regardless of the strategy used in the management of the cervical lymph nodes after chemoradiotherapy, all the studies agree that in case of neck dissection, the persistence of viable cancer cells in the neck is associated with a significant decline in survival …”

Section: Introductionmentioning

confidence: 99%

“…7,8 Regardless of the strategy used in the management of the cervical lymph nodes after chemoradiotherapy, all the studies agree that in case of neck dissection, the persistence of viable cancer cells in the neck is associated with a significant decline in survival. [1][2][3]5,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Several studies 27,28 and meta-analyses 29,30 conclude that the presence of metastatic lymph nodes with ECS, defined as extension of the tumor outside the lymph node capsule, has a high prognostic capacity, justifying the inclusion of the ECS as a criterion in the pathologic classification of the 8th edition of the TNM classification. 31 The objective of the present study is to evaluate the prognostic significance of metastatic neck nodes with ECS in a cohort of patients treated with a planned neck dissection after an initial treatment with chemoradiotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic role of extracapsular spread in planned neck dissection after chemoradiotherapy

et al. 2018

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Background The purpose of this study is to evaluate the prognostic significance of nodes with extracapsular spread (ECS) in patients treated with a planned neck dissection after chemoradiotherapy. Methods We carried out a retrospective study of 109 cN+ patients who achieved a complete response in the primary location after chemoradiotherapy and treated with a planned neck dissection. Results The 5‐year disease‐specific survival for patients without residual metastatic nodes in the neck dissection (pN0, n = 69) was 75.7% (95% CI: 64.4%‐87.0%). For patients with metastatic nodes without ECS (pN+/ECS‐negative, n = 17), the corresponding figure was 74.0% (95% CI: 48.2%‐99.8%), and for patients with metastatic neck nodes with ECS (pN+/ECS‐positive, n = 23) it was 8.7% (95% CI: 0.0%‐24.3%) (P = .0001). Conclusion The presence of ECS in the pathologic study of the planned neck dissections carried out after chemoradiotherapy in patients with human papillomavirus‐negative (HPV‐negative) head and neck squamous cell carcinoma (SCC) allows identification of a group of patients with a high risk of failure.

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Section: Discussionmentioning

confidence: 99%

“…The presence of viable tumoral cells in planned neck dissections after previous treatment with radiotherapy or chemoradiotherapy (pN+) has been associated to higher rates of local and regional failures, higher rates of appearance of distant metastases, and poorer overall and specific‐disease survival . However, there is little information about the pathologicl characteristics of the positive neck metastases in relation to the prognosis of the disease.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic role of extracapsular spread in planned neck dissection after chemoradiotherapy

et al. 2018

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The value of preoperative radiotherapy in the treatment of locally advanced nasal cavity and paranasal sinus squamous cell carcinoma: A single institutional experience

Wang

et al. 2020

Oral Oncology

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Pathologic Response Rates after Neoadjuvant Therapy for Sarcoma: A Single Institution Study

Seldon

Shrivastava

Fernández

et al. 2021

Cancers

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(1) Background: Pathologic necrosis of soft tissue sarcomas (STS) has been used to determine treatment response, but its relationship to neoadjuvant treatments remains indeterminate. In this retrospective, single institution study, we hypothesized that neoadjuvant chemoradiation (NA-CRT) yields higher rates of pathologic complete response (pCR) than neoadjuvant radiation (NA-XRT) or chemotherapy (NA-CT) alone. (2) Methods: Patients with extremity STS between 2011–2020 who received neoadjuvant treatment were included. pCR was defined as percent necrosis of the surgical specimen greater than or equal to 90%. (3) Results: 79 patients were analyzed. 51.9% of the population were male with a mean age of 58.4 years. 49.4% identified as Non-Hispanic White. Twenty-six (32.9%) patients achieved pCR while 53 (67.1%) did not. NA-CT (OR 15.82, 95% CI = 2.58–96.9, p = 0.003 in univariate (UVA) and OR 24.7, 95% CI = 2.88–211.2, p = 0.003 in multivariate (MVA), respectively) and NA-XRT (OR 5.73, 95% CI = 1.51–21.8, p = 0.010 in UVA and OR 7.95, 95% CI = 1.87–33.7, p = 0.005 in MVA, respectively) was significantly associated with non- pCR when compared to NA-CRT. The analysis also demonstrated that grade 3 tumors, when using grade 2 as reference, also had significantly higher odds of achieving pCR (OR 0.23, 95% CI = 0.06–0.80, p = 0.022 in UVA and OR 0.16, 95% CI = 0.04–0.70, p = 0.015 in MVA, respectively). (4) Conclusion: NA-CRT yields superior pCR compared to other neoadjuvant regimens. This extends to higher grade tumors.

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Complete pathologic response as a prognostic factor for squamous cell carcinoma of the oropharynx post-chemoradiotherapy

Abstract: The presence of a complete pathologic response after chemoradiotherapy positively influences the prognosis of patients with SCCO.

Cited by 3 publications

References 37 publications

Prognostic role of extracapsular spread in planned neck dissection after chemoradiotherapy

Prognostic role of extracapsular spread in planned neck dissection after chemoradiotherapy

The value of preoperative radiotherapy in the treatment of locally advanced nasal cavity and paranasal sinus squamous cell carcinoma: A single institutional experience

Pathologic Response Rates after Neoadjuvant Therapy for Sarcoma: A Single Institution Study

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